Abstract
BACKGROUND: Arterial blood gas (ABG) analysis is a critical diagnostic tool used in emergency and intensive care settings to assess a patient's acid-base balance, ventilation, and oxygenation. Despite its importance, ABG interpretation remains challenging for junior doctors, particularly when dealing with complex cases involving mixed respiratory and metabolic disturbances. This clinical audit was conducted to evaluate the baseline competency of junior doctors in ABG interpretation and to measure the impact of targeted educational interventions. Aim: This study aims to evaluate the baseline knowledge of junior doctors in ABG interpretation and to assess the impact of targeted educational interventions on improving their interpretation skills. METHODOLOGY: A prospective, two-cycle clinical audit was conducted at Dongola Teaching Hospital in Northern Sudan, involving 110 questionnaires, 55 in each cycle. The first cycle served as a baseline assessment using structured clinical scenarios based on American Thoracic Society (ATS) guidelines. After identifying deficiencies, educational interventions were implemented over a two-week period. These included focused lectures, visual posters, and small-group case discussions. The second cycle reassessed the same parameters using a revised version of the questionnaire to reduce recall bias. Data were analyzed using SPSS version 25, and statistical significance was evaluated using the chi-square test with p < 0.05 considered significant. Results: Significant improvements were observed in most key areas of ABG interpretation. The ability to assess compensation improved from 23 (42%) to 40 (72%) (p = 0.002), identifying respiratory vs. metabolic origin increased from 37 (68%) to 50 (90%) (p = 0.005), and detection of mixed acid-base disorders rose from 30 (54%) to 43 (78%) (p = 0.015). The calculation of anion gap improved from 35 (64%) to 47 (86%) (p = 0.009), and basic interpretation of pH disturbances increased from 41 (74%) to 48 (88%) (p = 0.15). Although some gains were not statistically significant, all areas demonstrated clinical relevance and educational benefit. CONCLUSION: The findings demonstrate that structured educational interventions can significantly enhance ABG interpretation skills among junior doctors, particularly in resource-limited settings. This audit supports the integration of focused, practical ABG training into routine junior doctor education and highlights the importance of ongoing assessment through audit cycles. Wider adoption of such strategies may contribute to improved diagnostic accuracy, timely interventions, and better patient outcomes.